CV System Changes Flashcards by Walter Adeyanju

Functional Capacity and Normal Age-
related Physiological Declines

We cannot stop the aging process!what that can be done is giving more functional reserve

Healthy lifestyle can also bump themselves up

Trained adult at any age on a higher parallel aging curve than untrained

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Functional Capacity and Normal Age-
related Physiological Declines

Independent functional reserve

Once you hit it you are no longer independent

Depending on your genetics you might not hit the line

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3 component of the Cardiovascular system

Heart

Serves as a pump

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3 component of the Cardiovascular system

Blood vessels

Passageways for blood to travel to all parts of the body and back to the heart

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3 component of the Cardiovascular system

Blood

Transport medium

Main goal of the Cardiovascular system is to transport material throughout the body

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Hypertension Stages

Normal

Mean SBP/DBP < 120/80 mmhg

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Hypertension Stages

Elevated
(Previously pre-hypertension)

Mean SBP 120-129 mmHg and DBP <80 mmHg

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Hypertension Stages
Stage 1 hypertension (Previously pre-hypertension)

Mean SBP 130-139 mmHg or mean DBP 80-89 mmHg

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Hypertension Stages
Stage 2 hypertension
(Previously hypertension)

Mean SBP ≥ 140 mmHg OR
Mean DBP ≥ 90 mmHg OR

Self-reported use of medication for high blood pressure within the past month OR

Self-reported having been diagnosed with hypertension by a health-care professional

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Systolic blood pressure (SBP)

Pressure exerted when heart beats and pumps blood

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Diastolic blood pressure

Pressure exerted when heart rest

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CV System – Structural Changes

Thickening (Arteries)

Thickening of the walls of the large arteries

With age the internal layer (tunica intima) of the artery thickens and fragments – a process similar to what happens with early
stage atherosclerosis

Even people with healthy heart show this,takes blame off older adults

2-3x the size of the artery

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CV System – Structural Changes

Stiffness

Increased stiffness of the large arteries, small
arteries, and arterioles (less compliant)

With age the regulation of vasodilation is impaired (vessels are less responsive to biochemical cues for dilation)

Increased resistance = increased blood pressure

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CV System – Structural Changes

Thickening (left ventricle)

Thickening of the walls of the left ventricle in response to thickening of the walls of the large arteries

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Does physical activity
have an effect on
lowering blood
pressure in older
adults?

Heart can adapt from the amount of exercise done, increasing the functionality of the heart (stronger heart)

Postural hypotension/Orthostatic intolerance: changing position quickly leads to a decrease in blood pressure

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Non pharmacological strategies to reduce blood pressure

The majority of non pharmalogical strategy to redce bp is exercise

3x a week for 3 months to see result

Any form of exercise, Aerobic or strength

Helps reconstruct ventricle walls

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Heart rate definition

number of times the heart beats in one
minute

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Heart Rate points

The average resting HR of older adults is not
significantly different from young adults

Maximum HR (associated with heavy exercise),
decreases 5-10 beats per minute each decade

Max HR calculation for individuals over 40 yrs:
208 - (0.7 x age)

Heart Rate points

The average resting HR of older adults is not
significantly different from young adults

Maximum HR (associated with heavy exercise),
decreases 5-10 beats per minute each decade

Max HR calculation for individuals over 40 yrs:
208 - (0.7 x age)

Sympathetic nerve

Reduced Sensitivity: The body becomes less responsive to norepinephrine, meaning the sympathetic nervous system is less activated during stress or exercise.

Receptor Changes: Adrenergic receptors (β-receptors) become less effective, leading to a reduced heart rate and contractility response during exertion.

Impaired Norepinephrine Uptake: Uptake mechanisms for norepinephrine may become less efficient, limiting cardiovascular adjustments during activity

Result: Older adults experience blunted cardiovascular responses, reduced exercise capacity, and slower recovery.

Does physical
activity have an effect
on max HR in
older adults?

Sedentary vs Endurance trained

There was no dramatic incline between both

Max heart rate is declining at the same rate no matter activity or not

Doesn’t change the sensitivity of the heart to norepinephrine

Stroke volume

the amount of blood (in ml) pumped
from the heart with each beat

How does resting supine stroke volume change with aging in men or women?

Resting supine stroke volume showed little change with
aging in men or women

How does stroke volume respond to increased activity with age?

Stroke volume changes in response to increased activity do not happen as efficiently with age due to several factors.

What factors contribute to less efficient stroke volume changes with age during increased activity?

Reduced heart muscle elasticity Slower heart rate response to activity Stiffer arteries Decreased contractile function of the heart Less efficient oxygen utilization

Cardiac Output –

the total amount of blood ejected from each ventricle of the heart in 1 min, expressed in litres per minute (L/min) Cardiac Output = Stroke volume x Heart Rate Q = SV x HR

How does cardiac output at rest compare between older and younger adults?

Cardiac output at rest is typically similar in both older and younger adults, as compensatory mechanisms maintain overall stability despite minor changes in stroke volume and heart rate.

How does cardiac output during exhaustive activity differ between older and younger adults?

Cardiac output during exhaustive activity is lower in older adults Heart rate drops and you cannot offset Cardiac output with just that

What is the arterio-venous oxygen difference ((a-v)O2 difference)?

It is the difference between the amount of oxygen transported in the arterial blood and the amount of oxygen transported in the mixed venous blood.

What is the typical (a-v)O2 difference at rest and during maximal exercise?

At rest: ~5 ml O2/100 ml blood During maximal exercise: ~15 ml O2/100 ml blood

How does the (a-v)O2 difference change with age?

The (a-v)O2 difference decreases with age. For example, a 65-year-old male has an (a-v)O2 difference 20-40% lower than a 25-year-old male

How does aging affect muscle oxygen extraction, and can training influence the (a-v)O2 difference?

With age, muscle becomes less effective at extracting oxygen and there is less muscle overall. However, a trained adult can improve their (a-v)O2 difference and become more effective at oxygen extraction through exercise.

What is VO2max, and how is it measured?

VO2max is the maximal rate at which oxygen can be taken up, distributed, and used by the body during exercise that engages a large muscle mass. It is measured in ml * kg⁻¹ * min⁻¹.

What is the formula for VO2max?

VO2max = Cardiac Output × (a-v)O2 difference

How does VO2max change with age, and why?

VO2max declines by about 1% per year after age 25. This decline is mainly due to a reduction in maximal heart rate.

VO2 max vs increase in age for Women (endurances-trained vs Sedentary)

10percent decline If individuals is sedentary Sedentary are closer to that individual function (15) (No longer independent)

VO2 max vs increase in age for Men (endurances-trained vs Active, Sedentary)

Rate of decline between groups are no different End point is different Absolute function levels are different Train to increase stroke volume and. A.V p, ore muscle in heart

Cardiopulmonary System

The heart operates in partnership with the lungs toensure the efficient transport of blood to and from the heart to facilitate the exchange of oxygen and carbon dioxide.

CP system – Structural Changes

Reduction in alveolar surface area Loss of elastic recoil of the lungs Increased chest wall stiffness Decreased inspiratory muscle strength (e.g. diaphragm, intercostals) Breathe less

Reduction in alveolar surface area

less surface area for gas exchange to occur

Loss of elastic recoil of the lungs

increase work required for respiration

Increased chest wall stiffness

increase work required for respiration

Decreased inspiratory muscle strength (e.g. diaphragm, intercostals)

increase work required for respiration

Breathless

System is not keeping up